Updated on July 27, 2020 at 1:45pm EST.
Racial health disparities in the United States include key markers of well-being that extend far beyond disease prevention and management, according to preliminary findings of Sharecare’s Community Well-Being Index (CWBI). These racial disparities—including the ability to live a purposeful and happy life, having the energy and financial freedom to achieve goals and feeling loved and supported on a daily basis—can significantly undermine people’s overall health and quality of life.
“For some of us, racism is the first pandemic we’ve experienced, and it has persisted for centuries,” says Jessica Brooks, CEO and executive director of the Pittsburgh Business Group on Health. “When compounded decade after decade and generation after generation in the form of housing discrimination, employment, and healthcare and other factors, the realities of poor health and total well-being are not surprising. We have an opportunity before us to change the trajectory and create a reality where total well-being can be realized for not some, but all.”
Identifying well-being inequality
In an attempt to garner insight into how the COVID-19 pandemic is affecting the BIPOC (black, indigenous and people of color) population in the United States, Sharecare’s CWBI collected more than 1,000 survey responses from around the country from June 5 to 8, 2020. Data collection was carried out using Qualtrics—an online survey platform.
Of the respondents, 50 percent were Black, 30 percent were Hispanic, and 20 percent were white.
Those surveyed were asked to record responses for questions tied to their physical, financial, and social well-being, their sense of community and purpose, and their perspectives on how the COVID-19 pandemic would affect their employment, financial obligations, and other aspects of their lives.
When asked to rate the validity of statements, such as, ‘I like what I do every day,’ and ‘I learn or do something interesting every day,’ the respondents who identify as Black or African American were roughly three times more likely than respondents who identify as white or caucasian to strongly disagree with those statements.
Similar racial disparities were found among aspects of physical well-being, or ‘having good health and enough energy to get things done daily.’ The survey found that the Black or African American respondents were more than twice as likely as the respondents who identify as white to strongly disagree that they felt active and productive each day for the past seven days. Meanwhile, they were nearly twice as likely as white respondents to report feeling down, depressed or hopeless more than half the days during the last two weeks.
When asked about their social well-being, or ‘having supportive relationships and love in your life,’ the Black or African Americans polled were more than twice as likely as the white adults polled to strongly disagree that someone in their life always encourages them to be healthy, and more than 1.5 times more likely to strongly disagree that they received positive energy from friends and loved ones on a daily basis.
The CWBI weekend snapshot also explored the respondents’ community well-being. Fewer than 1 in 5 respondents who identify as Black or African American strongly agreed that the city where they live is the perfect place for them. Yet, the Black or African Americans were nearly twice as likely as white respondents to strongly agree they have received recognition for helping to improve the city where they live within the last 12 months.
COVID-19 highlights inequalities
People of color, especially Black and African-American communities, have been disproportionately affected by the COVID-19 pandemic.
Across the United States, majority-Black counties have higher rates of infections and deaths as majority-white counties.
There are some factors specific to the novel coronavirus that could help explain this discrepancy. For example, people of color are more likely to live in places with high levels of air pollution, according to the American Lung Association. Research from the Harvard T.H. Chan School of Public Health suggests that people who’ve lived for many years in places with high levels of air pollution are more likely to die of COVID-19 than those who live in areas with less pollution.
People of color are also more likely to be uninsured or underinsured, which could prevent them from seeking medical attention.
In April, 115,000 Americans completed Sharecare’sFlatten the Curve survey, which was designed to assess and promote better understanding of the impact of COVID-19 on both individuals and populations. The survey showed that compared to individuals with private health insurance from an employer, those who are enrolled in Medicaid or do not have health insurance were more likely to indicate they would not seek care during the pandemic.
When it comes to financial well-being, defined as managing your economic life to increase security and reduce stress, the CWBI snapshot found additional racial inequalities.
Compared to white respondents, those who identify as Black or African American more often reported feeling worried about money within the last seven days. They were also more likely than the white respondents to have been laid off due to issues related to COVID-19, and more likely to report having trouble paying their bills during the pandemic.
“This snapshot brings to light one view of how Black and African Americans are experiencing well-being during this unprecedented time,” says Elizabeth Colyer, Sharecare’s senior vice president of the Community Well-Being Index. “It also demonstrates the continued white privilege that manifests into everyday well-being and overarching health outcomes”
Persistent racial health disparities
The racial health disparities reflected in Sharecare CWBI findings are longstanding, resulting from decades of systematic inequality in American economic, housing, and health care systems.
These results are underscored by the U.S. Office of Disease Prevention and Health Promotion (ODPHP), which asserts that race or ethnicity as well as sex, sexual identity, age, disability, socioeconomic status, and geographic location all affect people’s ability to achieve good health.
Although behavior, health habits and DNA can influence overall well-being, there are a number of social determinants of health, including access to healthcare, high-quality education, nutritious food, clean air and water, safe housing, affordable and reliable transportation as well as culturally-sensitive healthcare providers, according to the ODPHP.
The death rate among those who identify as Black or African American has declined during the past 17 years, but more recent research suggests that younger Black people are living with or dying from conditions usually diagnosed among white people at older ages, according to the Centers for Disease Control and Prevention (CDC).
In the United States, health disparities related to socioeconomic conditions, such as lack of access to healthcare due to financial strain, are also more common among Black people than whites, the CDC reports.
“At Sharecare,” Colyer adds, “our goal is to ensure that in the face of continued inequity and dissimilarity, community-driven care means both surfacing these data and identifying interventions that augment health outcomes for Black and African American populations, locally and nationally.”
“We must take immediate action to eradicate this disease called racism,” Brooks says. “The biggest mistake that can be made is to view this as a ‘them’ versus ‘us’ issue or a ‘black’ versus ‘white’ issue. Racism is the denial of access to quality, and at some moment, it will seep through boundaries of black and brown people for which it was intended, and impact those who have upheld the system. Our call is to take these insights and commit to collective action.”
For more information
Related prior Sharecare research linking to racial inequities in well-being and health outcomes include:
- 2017 research indicating Black populations experiencing lowest levels of life satisfaction
- 2016 research showing Black populations are least likely to say their city or community is the perfect place for them
- 2014 research demonstrating unemployment negatively affects well-being for young Black males
For additional information on this sample and Sharecare interventions targeted toward health improvement and outcomes, please contact CWBI@sharecare.com.